redfern material (exam 3) Flashcards
a deficiency in this inhibitory neurotransmitter is responsible for causing anxiety
GABA
T or F?
anxiety is always negative
false
why is it important to not stop a benzodiazepine abruptly?
rapid discontinuation will cause withdrawal
T or F?
there is no risk of dependence while taking benzo
false
what are the 3 meds to treat anxiety?
benzodiazepines, SSRIs, tricyclic antidepressants
what stage of sleep is dreams, more body movement, faster pulse, and increased breathing?
REM
adverse effects of benzodiazepines?
dizzy, drowsy, falls, confusion, depressed, seizures, nausea
what should be avoided while taking benzos
alcohol
T or F
you can administer grapefruit juice with meds
false
______ can interact with prescription meds, so make sure you know what your patient is taking
herbal supplements, OTC meds
T/F?
Benadryl when used in children can cause CNS excitability rather than CNS depression
true
what are the 3 neurotransmitters involved in pathophysiology of depression
norepinephrine, dopamine, serotonin
how long should a patient take an antidepressant medication before symptoms improve
4-6 weeks
what is the BBW for tricyclic antidepressants?
SI in adolescents, toxic in overdose
what are some adverse effects of tricyclic antidepressants
CNS: ortho hypo, nystagmus, restless, tremors
-cardiac dysrhythmias, myocardial depression
tricyclic antidepressants should not be used with what other drug class as serious implications can occur?
MAOIs (seizure/death)
what dietary teaching is needed for a patient on a MAOI
avoid tyramine rich foods (aged cheese, processed meat, beer, wine)
what can occur if a patient on a MAOI eats tyramine foods?
hypertensive crisis
what is the treatment of a hypertensive crisis?
phentolamine
what is the BBW for an atypical antipsychotic used for smoking cessation
neuropsychiatric reaction
what is the drug of choice for bipolar
lithium
how is lithium excreted
kidneys
explain importance of watching fluid/sodium intake while taking lithium
avoid toxicity
how often are serum drug concentrations of lithium required and when should they be taken?
2-3x weekly
should be in the morning, 12 hours after last dose
what is the neurotransmitter most prominently associated with schizophrenia and other psychotic disorders
dopamine
what are the 2 major drug classes of meds used to treat psychotic disorders?
typical first gen
atypical second gen
what is an example of a typical first generation anti-psychotic
chlorpromazine
what is an example of an atypical second generation anti-psychotic
clozapine
therapeutic effects of antipsychotic therapy usually occur over what time frame?
1-2 months
which gen of antipsychotics have lower risk side effects
second gen
what condition can occur as a result of long term antipsychotic use
tardive dyskinesia
what condition involves loss of muscle movement, muscle rigidity and tremors, shuffling gait, masked facies, and drooling?
drug induced Parkinson’s
why is it important for prescribers to limit number of doses that can be obtained with a stimulant
reduces dependence
reduces others abusing it when they dont have it prescribed
large doses of stimulants can lead to what?
excessive CNS stimulation and sympathetic nervous system stimulation
when should a stimulant be administered and why?
early in morning after awakening, last dose 6 hours before bedtime. children should take 30-45 mins before meals to minimalize appetite supressant
explain significance of drug holiday
can cause appetite suppression, so the child doesnt have to take during school. Allows return of normal function, maintain sensitivity to drug and reduce adverse effects. decreases weight loss and growth suppression
BBW for amphetamine related drugs
risk of dependence.
this has been added to all ADHD and narcolepsy drugs for risk of sudden death, CV probs, and psychosis and aggression
what neurotransmitter stimulates brains reward system and leads to compulsive drug administration/abuse
dopaminergic neurons
name 3 reasons why treatment of drug dependence is limited
1) only specific antidotes available
2) high risk for substituting drugs
3) drawbacks to giving CNS stimulants to reverse effects of CNS depressant and vice-verse
BBW of using benzos for alcohol wothdrawal
use of benzos with opioid anlgesics have serious adverse reactions including resp depression and death
patient should never consume what when taking antabuse? what household items should they avoid?
-alcohol
-cough syrup, mouth wash, vinegar, cologne, hand sanitizer
meds to treat opioid abuse?
methadone, natrexone, buprenorphine
BBW for methadone
needs to be approved for opioid addiction
deaths reported
emergency services on standby
monitor QT interval (prolongation)
T/F?
there are many proven pharmacological treatments related to CNS stimulant abuse / dependence?
false
